Objective: Evaluate short-term subjective and objective factors influencing long-term Positive Airway Pressure (PAP) compliance.

Methods: 61 patients commenced PAP treatment from October 2021 then monitored to February 2023. Polysomnography data, weekly compliance, physical and psychological examinations were performed for the initial 8-week period and analysed to predict compliance at week 8 (n=46,82.5%) and week 52 (54%).

Results: Week 8 PAP continuation associated with compliance>70% at week 2 [OR 29.8(3.4-264.5),p=0.000] and compliance >70% each week for 8 week trial [OR 21.7(2.5-189.7),p=0.000].

Week 8 PAP discontinuation associated with compliance<50% (week 2) and weekly (week 1-8)[OR 96(9.5-972.6),p=0.000]and elevated psychological resistance (week 2) [OR 12.5(1.7-90.5),p=0.003].

Factors associated with >90% compliance (week 52) include compliance>90% (week 2) [OR 10.6(2.4-46.0),p=0.001] and compliance >70% (weeks 1-8) [OR 14.7(1.7-126.4),p=0.003)].

Factors at week 2 associated with <10% compliance (week 52) include unsuccessful consultation [OR 23.3(2.2-246.2),p=0.000], AHI>5 [OR 81.7(7.4-904.1),p=0.000], mask discomfort [OR 23.3(2.2-246.2),p=0.000] and CPAP discomfort [OR 15(1.4-166.1),p=0.000]. 

Weekly(weeks 1-8) factors associated with <10% compliance (week 52) include mask leak>20L/min [OR 68 (8.3-558.6),p=0.000] and AHI>5 [OR 153.0 (12.4-1883.3),p=0.000].

Conclusions: Long-term PAP compliance appears influenced by early objective parameters e.g. compliance, mask leak and subjective parameters e.g. psychological resistance, mask discomfort, CPAP discomfort, failure to attend PAP consultations. These early predictors may further assist identify PAP-noncompliant patients for early targeted intervention. Ongoing subanalysis continues.